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VIRTUAL CHAPTER POLICY FORUM
Chicago & Indianapolis NHMA ChaptersCOVID-19 & Diversity in Health Care
September 16, 2020
7:00 PM – 8:15 PM EDT
www.NHMAmd.org @NHMAmd @NHMAmd.org
Welcome
Encourage your patients to enroll and inform others about the clinical trials for
COVID-19 Vaccines
◦ www.CoronaVirusPreventionNetwork.org
◦ www.COVIDVACCINESTUDY1.com
Instructions to receive CME will be included in thank you email. Webinar
recording & CME will be available for 1 year at www.NHMAmd.org/webinars
Pfizer, Inc.2
Elena Rios, MD, MSPH, FACP
President & CEO
National Hispanic Medical Association
Washington, DC
OverviewPilar Guerrero, MD
Chair, NHMA Chicago Chapter
Javier Sevilla-Martir, MD
Chair, NHMA Indianapolis Chapter
Housekeeping
o Presentations to be followed by 10-15 minute discussion
o Microphones will be muted
o Type questions in chat box
o Recording available next week at www.NHMAmd.org
Learner Notification
4
Objectives - After Attending This Program You Should Be Able To
To increase knowledge about Covid- 19 presentation symptoms and treatment in an acute emergency situation.
To increase knowledge about the need to increase diversity in the healthcare workforce, especially for Latinos and the insurance industry.
Disclosure of Conflict of Interest
The following table of disclosure information is provided to learners and contains the relevant financial relationships that each individual in a position to control the content disclosed to Amedco. All of
these relationships were treated as a conflict of interest, and have been resolved. (C7 SCS 6.1-‐6.2, 6.5)
All individuals in a position to control the content of CE are listed below.
National Hispanic Medical Association
Chicago/Indianapolis – COVID-19 and Access to Insurance
Date of CE Release: September 16, 2020
Date of CE Expiration: September 16, 2021
Location: Online
Acknowledgement of Financial Commercial Support
No financial commercial support was received for this educational activity.
Support
No in-kind commercial support was received for this educational activity.
Satisfactory Completion
Learners must listen to each self-directed audio recording while following along with the visual slides/read the articles, complete an evaluation form to receive a certificate of completion. You must
participate in the entire activity as partial credit is not available. If you are seeking continuing education credit for a specialty not listed below, it is your responsibility to contact your licensing/certification
board to determine course eligibility for your licensing/certification requirement.
In support of improving patient care, this activity has been planned and implemented by Amedco LLC and National Hispanic Medical Association. Amedco LLC is jointly
accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses
Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physicians
Amedco LLC designates this enduring material for a maximum of 1.00 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent
of their participation in the activity.
First Last Commercial Interest
Maria Gomez NA
Pilar Guerrero NA
Ben Melano NA
Elena Rios, MD, MSPH, FACP NA
Derek Robinson NA
Pamela Vergara-Rodriguez NA
Stopping COVID-19 in the Latinx
Chicagoland Community
Medical Provers Cannot Do This Alone
Dr. Pamela Vergara-Rodriguez
Internal Medicine/ Psychiatry and Addiction Medicine
IL Unidos
Cook County Hospital
5
http://illinoisunidos.com/
COVID 19 CASES PER 100,000 PERSONSBY RACE AND ETHNICITY - ILLINOISAPRIL 19 TO AUGUST 16, 2020 –LATINO POLICY FORUM
686
1771
2671
681
0
700
1400
2100
2800
3500
Asian Black Latino WhiteFuente: Illinois DPH, Censo de EE.UU y resumen diario de la COVID de Chicago; Análisis: Latino Policy Forum
Casos de COVID-19 por cada 100.000 Habitantes por Raza/Etnicidad, 16 de agosto, 2020, Illinois
COVID 19 CASES PER 100,000 PERSONSBY RACE AND ETHNICITY - ILLINOISAUGUST 16, 2020 –LATINO POLICY FORUM- IDPH DATA
PERCENT TEST POSITIVITY BY ETHNICITY-CUMULATIVE DATA IDPH WEBSITE ACCESSED AUG 20, 2020
Ethnicity is self-identified by the patient at the time of testing and is missing for ∼ 50% of tests.
PERCENT TEST POSITIVITY BY AGE-CUMULATIVE DATA IDPH WEBSITE ACCESSED AUG 20, 2020
Increasing test positivity among young age groups 20-29 , including Latinx
LATINOS ARE OVERREPRESENTED CHICAGO- 40% OF ALL POSITIVE TESTS
LATINX40%
AFRICAN AMERICAN
24%
WHITE14%
ASIAN2%
OTHER /?20%
CASES
Source: City of Chicago COVID19 Latest Data. Accessed August 20, 2020.
LATINX32.70%
AFRICAN AMERICAN
43%
WHITE19.20%
ASIAN4.30%
Other/UI0.80%
TOTAL DEATHS
ILLINOIS UNIDOS: WHO SELF APPOINTED VOLUNTEERS
▪Health Institutions▪Mt Sinai Health System, Univ.of Illinois , Northwestern
Univ., CCH (Medical Providers, Researchers, Program Coordinators)
▪Latino Specific Organizations▪Latino Policy Forum , ARISE ( Worker’s Rights), The Puerto
Rican Agenda, Chicago Hispanic Health Coalition,▪CBO’s▪Family Focus, A Safe Haven (Housing) , Rincon Family
Services , Trinidad Lutheran Church▪FQHCs▪Esperanza, Alivio, Erie Family Health, ACCESS
ILLINOIS UNIDOS: WHO SELF APPOINTED VOLUNTEERS
▪Government Representation▪CITY, COUNTY & STATE: State Representatives, Senators and Congressman, Local Alderman , IL State Board of Health , Chicago Board of Health , Judges and Clerks, General Consulte of Mexico , General Consulate of Guatemala
▪Private Institutions and Support :▪ Imagen Marketing consultants , Boca Media Group, Tanoma
Consulitng
▪Health Insurance ▪Next Level Health (managed care plan)
IL UNIDOS INITIATIVE : WHAT MITIGATE COVID 19 IMPACT ON LATINO COMMUNITY
▪REDUCE /STOP COVID-19 INFECTIONS▪PUBLIC AWARENESS CAMPAIGN▪ INCREASE OUTREACH AND EDUCATION
▪ Target small businesses and at risk businesses▪ INCREASE AND INFORM THE COMMUNITY ABOUT
CITY/STATE RESOURCES ▪ IMPROVE THE DATA -COVID DATA CORRECTION
▪ An Estimate that 50% of the unidentified race/ethnicity COVID positive test belong to Hispanics
▪ INCREASE SCREEENING AND TESTING▪ INCREASE REPRESENTATION OF LATINOS AT THE CITY
AND STATE LEVEL
IL UNIDOS : HOW ACITVELY SUPPORT POLICIES & LEVERAGE NETWORKS
▪ EMPOWER THE LATINO COMMUNITY- SOCIAL MEDIA ▪ Stop blaming the victims ▪ Identify the barriers to quarantine and shelter at home▪ Identify potential Intervention points
▪ADDRESS THE LACK OF RESOURCES FOR HISPANICS IMPACTED BY COVID-19
▪GET REPRESENTATION TO ADVOCATE FOR LATINX NEEDS▪ Economic Plan: Stimulus monies , Financial Resources, Future Economy▪ Contact Tracing ▪ Educational needs of children and parents▪ Current Influenza and Future COVID Vaccination
ILLINOIS UNIDOS: WHERE/WHEN ALL VIRTUAL
ZOOM Meeting: Weekly April 11 thru August 7, then Biweekly MeetingsSubcommittees:
Social Media, Health and Policy Committee, Educations Committee
Invited Speakers : Testimonials and FRONTLINE reportsMayor’s OfficeGovernor’s Office
Health Department Reps: City of Chicago and Illinois IL Dept of Education
MEDICAL PROVIDERS ON THE HEALTH & POLICY COMMITTE
Providing Up to date Frontline information and NeedsGuiding Focus of interventions and Press
Releases Lending Expertise on Education MaterialsLending eXPertise to CBOs and Alderman
Townhall meetingsProviding Representation on Taskforces
ILLINOIS UNIDOS: OUTCOMES- PRESS RELEASES
April 25, 2020- PRESS RELEASE #1 THE INITIATIVE – IL UNIDOS Immediate Priorities
May 1, 2020- PRESS RELEASE #2 Latinos may soon become the Largest group of positive COVID-19 cases in IL
May 6, 2020- PRESS RELEASE #3 Latinos now the largest group pf COVID-19 positive cases
May 28, 2020 - PRESS ELEASE #4 Il Latino COVID-19 Initiative urges stronger health response as State restrictions loosen
July 22 - PRESS RELEASE #5 IL Unidos calls on Industries with Latino workers to comply with COVID-19 safety protocols
POSITIVITY RATE
ILLINOIS UNIDOS: OUTCOMES- SOCIAL MEDIA
WGN/UNIVISION/WTTW/RADIO /NEWSPAPERS: NEWS INTERVIEWS and COMMENTS
Medical Personnel: Rise of Cases, Researchers: Data Correction
Latino Organization Leadership: Government Decisions andInterventions
FACEBOOK, TWITTER – future plans for a YouTube channel
OUTCOMES- REPRESENTATION
•TASKFORCES• State and City Health Equity Taskforce• State Data Collection • CITY of Chicago Anti Violence Task force• State Education TASK FORCE
•WORKING GROUPS• Education, Health Committees, Testing, contact tracing, Vaccination,
Small Business, Economic Stimulus
•CONTACT TRACING• Direct job amplification for Promotoras (Community healthcare workers)
and Contact Tracers
ILLINOIS UNIDOS: OUTCOMES:CURRENT/FUTURE… WINS/GOALS
1. Medicare Coverage for Persons over age 65yo Regardless of documentation of Immigration Status: DONE!!
2. Stimulus monies for Mixed Status Households: DONE! Not enough
3. Inclusion of Bicultural and Bilingual Promotoras for Contact Tracing : DONE!
4. Expansion of STATEWIDE Wireless ACCESS – still going!5. Appropriate RESOURCES allocated to the LATINO
COMMUNITY –FINANCIAL, HEALTH AND EMPLOYMENT- endless!
RESOURCES: FLOOD OF EMAILS
EDUCATIONLATINO Grocery Store outreach Education on Bookmarkers Infographic PDF’s – pictograms on basic COVID questions
HELP NUMBERSHOUSING RESOURCESUNEMPLOYMENT/ SMALL BUSINESS RESOURCESFOOD RESOURCESDIRECTORY OF COMPLAINT CENTERSmigrant workers, factory workers , Testing billsHEALTH ACCESS
Health insurance coverage for uninsured
HEALTH INSURANCE COVERAGE
Medical Insurance:• Medicaid, Medicare, Private Insurances • Co-Pays, Best to be in Network
▪ Medicare:• >65 y/o or Disabled• >65 y/o including undocumented persons
▪ Most Hospitals and FQHCs:
• Special program for persons who are undocumented and not eligible for State health insurance
▪ No Insurance :
• Apply for Medicaid in hospital or at the medical visit • < $24,000 per year per individual
• Apply for financial help to avoid bills• Need an ID (Consulate), dated proof of address (bill,
letter), proof of income (Check stubs, notarized letter of support)
AS A MEDICAL PROVIDER….
▪EXPLAIN QUARANTINE AND ISOLATION –THE WHY????
▪Address the Myths ▪VACCINATION!!!! Fear is the No. 1 ENEMY▪SELL Contact tracing ▪PARTNER WITH Community Based Organizations▪COMPLAIN TO GOVERNMENT REPS
HUGE THANK YOU TO THE IL UNIDOS FAMILY
http://illinoisunidos.com/
Latinos & COVID: The role of language
and race when creating resources
Dr. Maria V. Gomez
Emergency Medicine Physician
Mercy Health Javon Boe Hospital
26
Health Care disparities
Language and Race
Difference in:
Recall
Questions asked
Trust
Recall
Questions and Clarifications made
Trust
Trust continued
Era of Covid
Sources1. https://www.pewresearch.org/hispanic/2013/08/29/mapping-the-latino-population-by-state-county-and-city/
2. https://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf
3. https://regionalhca.org/hispanic-demographics/
1. https://news.yahoo.com/blogs/lookout/u-majority-minority-population-2043-census-predicts-164735561.html
1. Hispanic health in the USA: A scoping review of the literature. https://link.springer.com/article/10.1186/s40985-016-
0043-2
1. Language as a communication barrier in medical care for Hispanic patients.
https://journals.sagepub.com/doi/abs/10.1177/07399863910134001
1. Trust in physicians and medical institutions: What is it? Can it be measured? Does it matter?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2751209/pdf/milq_223.pdf
1. Language Matters: Race, Trust, and Outcomes in the Pediatric Emergency Department. https://journals-lww-
com.ezproxy.rush.edu/pec-
online/Fulltext/2016/04000/Language_Matters__Race,_Trust,_and_Outcomes_in_the.4.aspx
1. http://illinoisunidos.com
Insurer Approaches to Equity in Care
Derek J. Robinson, MD, MBA, FACEP, CHCQM
President
Blue Cross Blue Shield IL
40
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association
COVID-19Coverage Impacts
Source: Sara R. Collins et al., An Early Look at the Potential Implications of the COVID-19 Pandemic for Health Insurance Coverage, (Commonwealth Fund, June 2020).
Trends in the Rate of Uninsured by Race and Ethnicity
42
43
Note: For civilian
Americans, seasonally
adjusted. White, black and
Asian categories are not
exclusive of Hispanic
ethnicity.
Source: Labor Department, Washington Post
Unemployment Rate by Race
Source: Sara R. Collins et al., An Early Look at the Potential Implications of the COVID-19 Pandemic for Health Insurance Coverage, (Commonwealth Fund, June 2020).
16
27
18
31
24
21
Annualincome…
Annualincome…
White
Hispanic
Black
All
Data: Commonwealth Fund Health Care Poll: COVID-19, May–June 2020.
Percent of respondents age 18+
who said they and/or their
spouse/partner worked full-
time/part-time and had lost or were
furloughed from their job
In working households, one of five adults reported they and/or their
spouse or partner were laid off or furloughed from their job because of
COVID-19.
44
Source: Sara R. Collins et al., An Early Look at the Potential Implications of the COVID-19 Pandemic for Health Insurance Coverage, (Commonwealth Fund, June 2020).
21
7
10
14
53
Uninsured
Medicaid or individual market/marketplace plan
COBRA
Employer coverage*
Still covered through furloughedjob
* Employer coverage through respondent or spouse/partner’s employer.
Notes: Percentages are based on either respondent or respondent’s spouse/partner being enrolled in coverage. In a number of cases respondents affected by coverage loss reported a different source of coverage than spouses/partners who were also affected. Both types of coverage are reflected in the exhibit. Those who reported they are now enrolled in Medicare are not shown.
Data: Commonwealth Fund Health Care Poll: COVID-19, May–June 2020.
Percent of respondents age 18+ who said they
and/or their spouse/partner lost or were furloughed
from their job and had insurance through affected
job and either respondent and/or spouse/partner
was covered by one of the following types of
insurance
One of five adults who said that they or a spouse or partner had coverage through
a job affected by COVID-19 reported that at least one of them is now uninsured.
45
Source: Sara R. Collins et al., An Early Look at the Potential Implications of the COVID-19 Pandemic for Health Insurance Coverage, (Commonwealth Fund, June 2020).
Uninsured31%
…
Other*5%
Employer coverage^
28%
^ Employer coverage through respondent or spouse/partner’s employer or parent’s plan.
* Other includes respondents who reported “don’t know/refused.”
Data: Commonwealth Fund Health Care Poll: COVID-19, May–June 2020.
Percent of respondents age 18+ who said
they and/or their spouse/partner lost or
were furloughed from their job and
respondent did not have insurance through
affected job
Medicaid,
Medicare,
Individual market/
marketplace
About three of 10 respondents with no coverage through a job affected
by the pandemic are uninsured.
46
Source: Sara R. Collins et al., An Early Look at the Potential Implications of the COVID-19 Pandemic for Health Insurance Coverage, (Commonwealth Fund, June 2020).
65
81
71
77
80
74
Republicanor…
Democrator…
White
Hispanic
Black
All
Note: Adults who reported they considered themselves an “Independent,” “Other,” or reported “Don’t know/refused” were then asked if they lean more toward the Democratic or Republican Party.
Data: Commonwealth Fund Health Care Poll: COVID-19, May–June 2020.
Millions of Americans get their health insurance through a job. Should people who get health insurance
through their employers have the option of getting similar coverage at a similar cost through
government-regulated
and -subsidized health plans?
Percent of respondents
age 18+ who said “yes”
What do Americans think of providing people who have employer
coverage with a new option to buy insurance on their own?
47
Health Equity and Value Based Care
48
Provider Cultural Competency and Implicit Bias Training HMO Illinois
& ACOs
49
50
(Similar Program Implemented in with IPAs servicing our HMO products)
• 2017 – In 2017, initial attempts for ACOs to start Race / Ethnicity /
Language (REL) stratification yielded 2 ACOs – Cancer Screening Diabetes
• Today – In 2020, BCBSIL has 20 ACO contracts with 11 ACOs participating
in Race / Ethnicity / Language (REL) stratification
2020 ACO Contract Components
2020 2021 2022
HE CME – Physician Bias R/E/L Stratification Interventions
R/E/L Analysis Concept
(HEDIS Metrics/Initiation)Asthma / Diabetes / Hypertension SDoH Screening
BCBSIL 2020 ACO Contracts – HE/SDoH Overview
• BCBSIL and AHA are working together to
support IL hospitals in improving health
equity
• 13 hospital grantees including the following:
51
Health Equity Grant Program
51
American Heart Association Social Impact Fund Supported by a $1 million investment from Blue Cross and Blue Shield of Illinois, the program empowers communities on Chicago’s West and South sides to change their own trajectory of health and well-being by addressing issues of economic growth, healthy food access, housing and educational opportunity.
52
53
SOCIAL IMPACT FUND
Chicago South Multipurpose Center | 2020
Social Determinants of Health
Investing In Our Communities
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association
Blue DoorNeighborhood Center
SM
What is the Blue Door Neighborhood Center?
Job readiness and financial
literacy seminarsHealth education and wellness classes
Zumba, yoga, and line dancing
Affordable housing seminars
Care Coordination (Medicaid/MMAI Members)
Meeting space for 501 (c)3 non-profit organizations
The goal of the Blue Door Neighborhood Center is to help improve community health.
The Blue Door Neighborhood Center provides high touch, face-to-face engagement through care
coordination; prevention and education; health and wellness programs; community resource
awareness; and use of no-cost meeting space to non-profit organizations aligned with our vision.
55
Evidence of previous engagement through events, partnerships,
grants & sponsorships
How Are Locations Selected?
Ensure the location is accessible via multiple
means of transportation
Use hardship index to evaluate if we can make
positive impact on community health
Presence Accessibility Opportunity
Pullman
756 E. 111th St.
Morgan Park
11840 S. Marshfield Ave.
South Lawndale
2551 W. Cermak Rd.
56
Programs and Services
The Blue Door Neighborhood Center provides (1) condition management, (2) health
promotion, and (3) SDoH programming aimed at improving health; reducing disease risks;
providing education to manage chronic illness; and improving the overall well-being and
self-sufficiency of the South Lawndale community.
THREE-PRONGED APPROACH
Condition Management Health Promotion
Nutrition Diabetes AsthmaHeart
Disease
Behavioral
Health
Parent and
Child Wellness
Social Determinants
of Health Programming
57
© 2020 Blue Cross and Blue Shield of Illinois • All Rights Reserved 58
Wash and Wear Community Face Mask
Project, a BCBSIL collaboration between
Medline, the YMCA of Greater Chicago and
Knowality.
50 BCBSIL volunteers who worked to
distribute 100,000 reusable masks in
Chicago neighborhoods hardest-hit by
COVID-19.
BCBSIL COVID-19
Community Collaboration
Fund released (75)
$20,000 grants to
organizations around the
state.
Supporting Communities thru COVID-19
$500,000 to the
Chicago Community
Covid-19 Response
Fund
$1 Million donation to the
Illinois COVID-19 Response
Fund
Purchased and donated
150,000 KN95 masks for use
by front-line Illinois providers in
Illinois in collaboration with our
labor clients and the
Teamsters Joint Council 25 of
Chicago.
59
Member Cost-Sharing Waived
Telehealth Expanded
Grace Period Extensions
Community Investments
COVID-19 Economic
Response Program
Estimated Approx.
$300M
BCBSIL COVID-19 Investments
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